The telomere complex and the origin of the cancer stem cell.

Exquisite regulation of telomere length is essential for the preservation of the lifetime function and self-renewal of stem cells. However, multiple oncogenic pathways converge on induction of telomere attrition or telomerase overexpression and these events can by themselves trigger malignant transformation. Activation of NFκB, the outcome of telomere complex damage, is present in leukemia stem cells but absent in normal stem cells and can activate DOT1L which has been linked to MLL-fusion leukemias. Tumors that arise from cells of early and late developmental stages appear to follow two different oncogenic routes in which the role of telomere and telomerase signaling might be differentially involved. In contrast, direct malignant transformation of stem cells appears to be extremely rare. This suggests an inherent resistance of stem cells to cancer transformation which could be linked to a stem cell'specific mechanism of telomere maintenance. However, tumor protection of normal stem cells could also be conferred by cell extrinsic mechanisms.

Intrathecal Administration of an Anti-nociceptive Non-CpG Oligodeoxynucleotide Reduces Glial Activation and Central Sensitization.

Inflammatory pain associates with spinal glial activation and central sensitization. Systemic administration of IMT504, a non-CpG oligodeoxynucleotide originally designed as an immunomodulator, exerts remarkable anti-allodynic effects in rats with complete Freund´s adjuvant (CFA)-induced hindpaw inflammation. However, the anti-nociceptive mechanisms of IMT504 remain unknown. Here we evaluated whether IMT504 blocks inflammatory pain-like behavior by modulation of spinal glia and central sensitization. The study was performed in Sprague Dawley rats with intraplantar CFA, and a single lumbosacral intrathecal (i.t.) administration of IMT504 or vehicle was chosen to address if changes in glial activation and spinal sensitization relate to the pain-like behavior reducing effects of the ODN. Naïve rats were also included. Von Frey and Randall-Selitto tests, respectively, exposed significant reductions in allodynia and mechanical hypersensitivity, lasting at least 24 h after i.t. IMT504. Analysis of electromyographic responses to electrical stimulation of C fibers showed progressive reductions in wind-up responses. Accordingly, IMT504 significantly downregulated spinal glial activation, as shown by reductions in the protein expression of glial fibrillary acidic protein, CD11b/c, Toll-like receptor 4 (TLR4) and the phosphorylated p65 subunit of NFκB, evaluated by immunohistochemistry and western blot. In vitro experiments using early post-natal cortical glial cultures provided further support to in vivo data and demonstrated IMT504 internalization into microglia and astrocytes. Altogether, our study provides new evidence on the central mechanisms of anti-nociception by IMT504 upon intrathecal application, and further supports its value as a novel anti-inflammatory ODN with actions upon glial cells and the TLR4/NFκB pathway. Intrathecal administration of the non-CpG ODN IMT504 fully blocks CFA-induced mechanical allodynia and hypersensitivity, in association with reduced spinal sensitization. Administration of the ODN also results in downregulated gliosis and reduced TLR4-NF-κB pathway activation. IMT504 uptake into astrocytes and microglia support the concept of direct modulation of CFA-induced glial activation.

Neumonía adquirida en la comunidad: tratamiento ambulatorio y prevención / Community acquired pneumonia in children: Outpatient treatment and prevention

La neumonía adquirida en la comunidad (NAC) en la edad pediátrica ha sufrido, en la última década, una serie de cambios epidemiológicos, clínicos, etiológicos y de resistencias a antibióticos, que obligan a replantear su abordaje terapéutico. En este documento, dos de las principales sociedades de especialidades pediátricas involucradas en el diagnóstico y tratamiento de esta entidad, como son la Sociedad Española de Infectología Pediátrica y la Sociedad Española de Neumología Pediátrica, así como el Comité Asesor de Vacunas de la AEP, proponen unas pautas consensuadas de tratamiento y prevención, con el fin de proporcionar a todos los pediatras una guía actualizada. En esta primera parte del consenso, se aborda el tratamiento de los pacientes sin enfermedades de base relevantes con NAC que no precisan ingreso hospitalario, así como la prevención global de esta patología con vacunas. En un siguiente documento se expondrá el abordaje terapéutico tanto de aquellos pacientes en situaciones especiales como de las formas complicadas de la enfermedad

There have been significant changes in community acquired pneumonia (CAP) in children in the last decade. These changes relate to epidemiology and clinical presentation. Resistance to antibiotics is also a changing issue. These all have to be considered when treating CAP. In this document, two of the main Spanish pediatric societies involved in the treatment of CAP in children, propose a consensus concerning therapeutic approach. These societies are the Spanish Society of Paediatric Infectious Diseases and the Spanish Society of Paediatric Chest Diseases. The Advisory Committee on Vaccines of the Spanish Association of Paediatrics (CAV-AEP) has also been involved in the prevention of CAP. An attempt is made to provide up-to-date guidelines to all paediatricians. The first part of the statement presents the approach to ambulatory, previously healthy children. We also review the prevention with currently available vaccines. In a next second part, special situations and complicated forms will be addressed

Neumonía adquirida en la comunidad: tratamiento de los casos complicados y en situaciones especiales. Documento de consenso de la Sociedad Española de Infectología Pediátrica (SEIP) y Sociedad Española de Neumología Pediátrica (SENP) / Community acquired pneumonia in children: Treatment of complicated cases and risk patients. Consensus statement by the Spanish Society of Paediatric Infectious Diseases (SEIP) and the Spanish Society of Paediatric Chest Diseases (SENP)

Desde hace más de una década, los casos complicados de neumonía adquirida en la comunidad, fundamentalmente con empiema pleural o formas necrosantes, comenzaron a ser más frecuentes en niños, según la amplia documentación procedente de numerosos países. El abordaje terapéutico óptimo de estos casos, tanto desde el punto de vista médico (antibióticos, fibrinolíticos) como técnico-quirúrgico, (drenaje pleural, videotoracoscopia) continúa siendo controvertido. En este documento, la Sociedad Española de Infectología Pediátrica y la Sociedad Española de Neumología Pediátrica revisan la evidencia científica y proponen unas pautas consensuadas de tratamiento de estos casos, fundamentalmente para el abordaje del derrame pleural paraneumónico en niños, así como la actuación en situaciones especiales, sobre todo en la cada vez más frecuente población pediátrica con enfermedades de base o inmumodepresión

The incidence of community-acquired pneumonia complications has increased during the last decade. According to the records from several countries, empyema and necrotizing pneumonia became more frequent during the last few years. The optimal therapeutic approach for such conditions is still controversial. Both pharmacological management (antimicrobials and fibrinolysis), and surgical management (pleural drainage and video-assisted thoracoscopic surgery), are the subject of continuous assessment. In this paper, the Spanish Society of Paediatric Infectious Diseases and the Spanish Society of Paediatric Chest Diseases have reviewed the available evidence. Consensus treatment guidelines are proposed for complications of community-acquired pneumonia in children, focusing on parapneumonic pleural effusion. Recommendations are also provided for the increasing population of patients with underlying diseases and immunosuppression

Mucociliary clearance techniques for treating non-cystic fibrosis bronchiectasis: Is there evidence?

Non-cystic fibrosis bronchiectasis (nCFb) is an acquired condition of variable etiology. An impaired mucociliary clearance seems to be one of the mechanisms behind nCFb, and treatment involves antibiotics, mucoactive agents, and airway clearance techniques (ACTs). Traditional ACTs have four components: postural drainage, percussion, vibration of the chest wall, and coughing. Reviewing the international medical literature on the use of ACTs for patients with nCFb from 1989 to the present day, we retrieved 93 articles, of which 35 met our selection criteria for this analysis. We reviewed active cycle of breathing techniques (ACBT), forced expiration techniques (FET), autogenic drainage, postural drainage, oscillating positive expiratory pressure (OPep), high frequency chest wall oscillation (HFCWO), and exercise or pulmonary rehabilitation. Overall, ACTs appear to be safe for individuals (adults and children) with stable bronchiectasis; where there may be improvements in sputum expectoration, selected measures of lung function, and health-related quality of life. Unfortunately, there is a lack of RCTs in nCFb patients, especially in children. Moreover, none of the studies describes long-term effects of ACTs. It should be noted that a single intervention might not reflect the longer-term outcome and there is no evidence to recommend or contest any type of ACTs in nCFb management. Multicenter RCTs are necessary to evaluate the different techniques of ACTs especially in children with nCFb.

[Community acquired pneumonia in children: Treatment of complicated cases and risk patients. Consensus statement by the Spanish Society of Paediatric Infectious Diseases (SEIP) and the Spanish Society of Paediatric Chest Diseases (SENP)]. / Neumonía adquirida en la comunidad: tratamiento de los casos complicados y en situaciones especiales. Documento de consenso de la Sociedad Española de Infectología Pediátrica (SEIP) y Sociedad Española de Neumología Pediátrica (SENP).

The incidence of community-acquired pneumonia complications has increased during the last decade. According to the records from several countries, empyema and necrotizing pneumonia became more frequent during the last few years. The optimal therapeutic approach for such conditions is still controversial. Both pharmacological management (antimicrobials and fibrinolysis), and surgical management (pleural drainage and video-assisted thoracoscopic surgery), are the subject of continuous assessment. In this paper, the Spanish Society of Paediatric Infectious Diseases and the Spanish Society of Paediatric Chest Diseases have reviewed the available evidence. Consensus treatment guidelines are proposed for complications of community-acquired pneumonia in children, focusing on parapneumonic pleural effusion. Recommendations are also provided for the increasing population of patients with underlying diseases and immunosuppression.

[Community acquired pneumonia in children: Outpatient treatment and prevention]. / Neumonía adquirida en la comunidad: tratamiento ambulatorio y prevención.

There have been significant changes in community acquired pneumonia (CAP) in children in the last decade. These changes relate to epidemiology and clinical presentation. Resistance to antibiotics is also a changing issue. These all have to be considered when treating CAP. In this document, two of the main Spanish pediatric societies involved in the treatment of CAP in children, propose a consensus concerning therapeutic approach. These societies are the Spanish Society of Paediatric Infectious Diseases and the Spanish Society of Paediatric Chest Diseases. The Advisory Committee on Vaccines of the Spanish Association of Paediatrics (CAV-AEP) has also been involved in the prevention of CAP. An attempt is made to provide up-to-date guidelines to all paediatricians. The first part of the statement presents the approach to ambulatory, previously healthy children. We also review the prevention with currently available vaccines. In a next second part, special situations and complicated forms will be addressed.

Histopathological study comparing upstream binding factor expression and AgNOR staining.

AgNOR staining has been in past years, the subject of numerous publications, which have failed to reach agreement regarding its usefulness as a proliferation marker. This silver staining method does not react with NORs (actual chromosome regions containing rRNA (ribosomal RNA) genes), but with proteins associated with them, whose quantity increases in parallel with ribosome biogenesis. The transcription factor UBF (upstream binding factor) is associated with NORs and has an important regulatory role in rRNA synthesis as cofactor of RNA polymerase I. Recent research has revealed an additional cytoarchitectural function of UBF in decondensing r-chromatin (ribosomal-chromatin). Immune detection of UBF expression and AgNOR counts are closely correlated as both techniques identify substrates in or closely adjacent to NORs. However, contrary to AgNOR dots, the UBF signal disappears in cells which undergo apoptosis or terminal differentiation. These features imply that UBF evaluation would reflect tumour cell proliferation (growth fraction) more accurately than AgNOR counts. Here we also show that immunohistochemical staining of UBF may reveal distinct active NORs with open, decondensed chromatin and we hypothesize that the large stretches of decondensed r-chromatin revealed by UBF staining may correspond to clusters seen after silver staining and, conversely, shorter areas of decondensed r-chromatin should match the small AgNOR grains typically found in some tumour types. The length of decondensed r-chromatin may be a reflection of the ratio of active to silent r-RNA genes.

Asma en el prescolar / Asthma in the pre-school child

El asma es una enfermedad difícil de diagnosticar en el lactante y prescolar, ya que a esa edad sus manifestaciones clínicas, tos sibilancias, taquipnea pueden darse también en otros procesos y no se cuenta con marcadores objetivos que permitan diferenciados. Se hace, por tanto, necesario valorar la respuesta al tratamiento broncodilatador y/o antinflamatorio y, si no es efectivo, derivar al niño a neumología y plantear un diagnóstico diferencial con otras enfermedades "sibilantes". La catalogación del niño en un determinado fenotipo puede servir de ayuda, aunque los fenotipos no son excluyentes entre sí y se definen mejor retrospectivamente; por eso, otra opción es la clasificación evolutiva de las sibilancias, como virales episódicas o a múltiples estímulos, con un pronóstico y tratamiento distintos. La aplicación de índices predictivos de asma (IPA) permite diferencia a los probables asmáticos y plantear tratamientos más selectivos. El inhalador presurizado aplicado con cámara pequeña con mascarilla facial es el método de elección para la administración de fármacos. Montelukast es el fármaco de elección para las sibilancias inducidas por virus y los corticoides inhalados, a dosis bajas, la opción terapéutica en los niños con sibilancias recurrentes a múltiples estímulos con IPA positivo (AU)

Asthma is a difficult disease to diagnose in infants and preschool because, at that age, their clinical manifestations (cough, wheezing, tachypnea), may also occur in other processes, and there is no objective markers that allow then apart. It is therefore necessary to assess response to treatment, bronchodilators and/or anti-inflammatory, and if not effective, refer the child to pediatric pulmonology and rise a differential diagnosis with other diseases "wheezing". The cataloging of the child in a particular phenotype may be helpful, although the phenotype may be helpful, although the phenotypes are not mutually exclusive and are best defined retrospectively; so, another options is the evolutionary classification of wheezing, as episodic viral or multiple stimuli, with a different prognosis at treatment. Application of asthma predictive index (API) differentiating the probable asthmatics and raise more selective treatments. The MDI applied with a small camera with face mask is the method of choice for drug delivery. Montelukast is the drug of choice for virus-induced wheezing and inhaled corticosteroids at low doses, the therapeutic option in children with recurrent wheezing to multiple stimuli with positive API (AU)

Oligodeoxynucleotide IMT504: lack of effect on immune parameters during islet regeneration in single dose streptozotocin-induced diabetes.

BACKGROUND: We have shown that oligodeoxynucleotide IMT504 improved blood glucose and islet beta-cell content in streptozotocin (STZ)-induced diabetic rats, inducing early expression of progenitor markers. Here we determined the effect of IMT504 on islet infiltration and on immunomodulatory proteins indoleamine 2,3-dioxygenase (IDO) and TNF-α-stimulated gene/protein 6 (TSG-6) in islets of STZ-diabetic rats, at the time of progenitor markers expression. METHODS: Male rats were i.p. injected with STZ [60 mg/kg body weight (BW)] or citrate buffer (control) (day 1). Starting on day 4, STZ animals were daily treated with saline (STZ-saline) or IMT504 (20 mg/kg BW/day s.c., STZ-IMT504) and killed after two consecutive decreases in blood glucose. Islet area and insulin expression, CD3 (T lymphocytes), CD68 (macrophages), IDO and TSG-6 immunostainings were determined. Islet infiltration was also evaluated by haematoxylin staining. RESULTS: STZ-induced diabetes in rats, with an important decrease in islet area was reversed by IMT504. Diabetes development did not involve islet infiltration, determined by haematoxylin and by the absence of significant T lymphocyte and macrophage presence. IMT504 did not induce changes in these parameters. IDO was not expressed in controls; the percentages of IDO-positive islets were very low and similar in STZ-saline and STZ-IMT504. Scarce TSG-6 was expressed in all groups, without significant differences. CONCLUSIONS: IMT504 improved insulin content but did not alter IDO or TSG-6 staining in islets of STZ-diabetic rats, suggesting that they do not participate in the IMT504-induced repair process. IMT504 did not per se modify leukocyte presence in islets of diabetic rats.

Carcinoma de tiroides en Pediatría: seguimiento a 30 años / Thyroid carcinoma in pediatrics: a 30-year follow-up

Introducción. Los tumores tiroideos son neoplasias de presentación infrecuente en la población pediátrica. El objeto de este estudio fue valorar la evolución terapéutica y seguimiento (supervivencia) a lo largo de 30 años. Materiales. Se revisaron 28 casos con diagnóstico de carcinoma de tiroides desde 1978 a 2008. Las variables a estudiar fueron: epidemiológicas, métodos diagnósticos utilizados, tipo de histología, tratamiento y supervivencia a 300 meses posterior al tratamiento. Consideramos como significativo una p<0,05. Resultados. El 73,1% de los casos fueron de sexo femenino. La edad promedio fue 12,3 años (1,6-19). La ecografía fue la prueba más solicitada (78,5%). La mutación RET se presento en tres casos asociados a MEN. El tipo histológico papilar fue el más frecuente (50%). Latiroidectomía total (TT) fue la cirugía más practicada (67,9%). La radioiodoablación (RIA) se usó en el 46,4% de los casos. La terapia de sustitución hormonal se usó en 27 pacientes de la serie. El 89,29% de la serie al cabo de 300 meses se encontraron libres de enfermedad. Conclusiones. El tratamiento de la serie ha variado a lo largo de (..) (AU)

Introduction. The thyroid tumours are infrequent neoplasms of presentation in paediatric. The object of this study was to value therapeutic evolution and the survival throughout 30 years. Materials. 28 cases with diagnosis of thyroid carcinoma. Were reviewed from 1978 to 2008. Were the variables to study: epidemiologists, methods used diagnostic, type of histology, later treatment and survival to 300 months to the treatment. We like considered significant p <0.05. Results. 73.1% of the cases were of feminine sex. The average age was 12.3 years (1.6 to 19). The ultrasound was asked for the test more(78.5%). The RET mutation associated appear in three cases to MEN. The histology type to papillary was most frequent (50%). The total thyroidectomy (TT) was the (..) (AU)

Diagnóstico de la tuberculosis en la edad pediátrica. Documento de consenso de la Sociedad Española de Infectología Pediátrica (SEIP) y la Sociedad Española de Neumología Pediátrica (SENP) / Diagnosis of tuberculosis in pediatrics. Consensus document of the Spanish Society of Pediatric Infectology (SEIP) and the Spanish Society of Pediatric Pneumology (SENP)

La tuberculosis continúa siendo uno de los problemas sanitarios más importantes en el mundo. En países desarrollados se está asistiendo a un aumento de casos, incluidos los niños, por diferentes motivos. El más determinante parece ser la inmigración procedente de zonas con elevada endemia de tuberculosis. Es prioritario que se establezcan las medidas necesarias para optimizar el diagnóstico precoz y adecuado de las distintas formas clínicas de tuberculosis en niños. Para ello, la Sociedad Española de Infectología Pediátrica (SEIP) y la Sociedad Española de Neumología Pediátrica (SENP), ambas pertenecientes Asociación Española de Pediatría, han decidido realizar el presente documento de consenso con el objetivo de unificar los criterios de actuación diagnóstica en la edad pediátrica (AU)

Tuberculosis is one of the most important health problems worldwide. There are an increased number of cases, including children, due to different reasons in developed countries. The most likely determining cause is immigration coming from high endemic areas. Measures to optimize early and appropriate diagnosis of the different forms of tuberculosis in children are a real priority. Two Societies of the Spanish Pediatric Association (Spanish Society of Pediatric Infectology and Spanish Society of Pediatric Pneumology) have agreed this Consensus Document in order to homogenize diagnostic criteria in pediatric patients (AU)

Leukotriene B4 and 8-isoprostane in exhaled breath condensate of children with episodic and persistent asthma.

BACKGROUND: Leukotrienes and isoprostanes are biomarkers of airway inflammation and oxidative stress that can be detected in exhaled breath condensate (EBC). The aim of this study was to evaluate leukotriene B4 (LTB4) and 8-isoprostane levels in EBC of healthy and asthmatic children with episodic and moderate persistent asthma. METHODS: EBC was collected from 62 children aged 6 to 14 years: 22 healthy children, 30 patients with episodic asthma, and 10 patients with moderate persistent asthma, without preventive treatment at the time of enrolment. RESULTS: LTB concentrations were higher in children with asthma than in healthy controls (50.7 pg/mL vs. 13.68 pg/mL, P < .011). The same was true for children with moderate persistent asthma compared to children with episodic asthma (146.9 pg/mL vs. 18.85 pg/mL, P < .0001), children with moderate persistent asthma compared to healthy controls (146.9 pg/mL vs. 13.68 pg/mL, P < .0001), and children with episodic asthma compared to healthy controls (P, nonsignificant). EBC concentrations of 8-isoprostane were higher in asthmatic than in healthy children (18.3 pg/mL vs. 6.59 pg/mL, P < .026). They were also increased in children with moderate persistent asthma compared to those with episodic asthma (36.25 pg/mL and 12.28 pg/mL, P < .012), and in children with moderate persistent asthma and episodic asthma compared to healthy controls (36.25 pg/mL vs. 6.59 pg/mL [P < .0001] and 12.28 pg/mL versus 6.59 pg/mL [P < .0001], respectively). CONCLUSION: LTB4 and 8-isoprostane concentrations were increased in asthmatic children compared to healthy individuals, with differences detected for 2 degrees of asthma severity. Our findings suggest that EBC is a noninvasive method for airway inflammation and oxidative stress assessment.

Diagnóstico de la tuberculosis en la edad pediátrica / Diagnosis of tuberculosis in paediatrics

La tuberculosis continúa siendo uno de los problemas sanitarios más importantes en el mundo. En países desarrollados se está asistiendo a un aumento de casos, incluidos los niños, por diferentes motivos. El más determinante parece ser la inmigración procedente de zonas con elevada endemia de tuberculosis. Es prioritario que se establezcan las medidas necesarias para optimizar el diagnóstico precoz y adecuado de las distintas formas clínicas de tuberculosis en niños. Para ello, la Sociedad Española de Infectología Pediátrica y la Sociedad Española de Neumología Pediátrica ambas pertenecientes a la Asociación Española de Pediatría, han decidido realizar el presente documento de consenso, con el objetivo de unificar los criterios de actuación diagnóstica en la edad pediátrica (AU)

Tuberculosis is one of the most important health problems worldwide. There are an increasing number of cases, including children, due to different reasons in developed countries. The most likely determining cause is immigration from highly endemic areas. Measures to optimise early and appropriate diagnosis of the different forms of tuberculosis in children are a real priority. Two Societies of the Spanish Paediatric Association (Spanish Society of Paediatric Infectology and Spanish Society of Paediatric Pneumology) have agreed this Consensus Document in order to homogenise diagnostic criteria in paediatric patients (AU)

[Diagnosis of tuberculosis in pediatrics. Consensus document of the Spanish Society of Pediatric Infectology (SEIP) and the Spanish Society of Pediatric Pneumology (SENP)]. / Diagnóstico de la tuberculosis en la edad pediátrica. Documento de consenso de la Sociedad Española de Infectología Pediátrica (SEIP) y la Sociedad Española de Neumología Pediátrica (SENP).

Tuberculosis is one of the most important health problems worldwide. There are an increased number of cases, including children, due to different reasons in developed countries. The most likely determining cause is immigration coming from high endemic areas. Measures to optimize early and appropriate diagnosis of the different forms of tuberculosis in children are a real priority. Two Societies of the Spanish Pediatric Association (Spanish Society of Pediatric Infectology and Spanish Society of Pediatric Pneumology) have agreed this Consensus Document in order to homogenize diagnostic criteria in pediatric patients.

Oligodeoxynucleotide IMT504 induces a marked recovery in a streptozotocin-induced model of diabetes in rats: correlation with an early increase in the expression of nestin and neurogenin 3 progenitor cell markers.

AIMS/HYPOTHESIS: IMT504 is an oligonucleotide that promotes tissue repair in bone injury and neuropathic pain models by stimulating progenitor cells. Here we evaluated the effect of IMT504 on the recovery of islet function in a streptozotocin (STZ)-induced model of diabetes in the rat. METHODS: Male Sprague-Dawley rats were injected with STZ (60 mg/kg, i.p., day 1) or citrate buffer (Control). Animals with glycaemia between 11 and 20 mmol/l on day 4 were injected with IMT504 (4 mg/animal in saline, s.c., STZ-IMT504) or with saline (STZ-Saline) for 10 days. Glycaemia and water and food intake were recorded for 33 days. Intraperitoneal glucose tolerance tests (IPGTTs) were performed on day 30. On day 35, overnight-fasted animals were killed and blood samples and pancreases collected for hormonal and histological studies. A second group of STZ-IMT504 rats was killed, together with Control and STZ-Saline rats, after two consecutive days of blood glucose decreases after the beginning of IMT504 treatment. Pancreases were collected and proliferating cell nuclear antigen (PCNA), nestin and neurogenin 3 (NGN3) detected by immunohistochemistry. RESULTS: IMT504 greatly improved blood glucose and food and water intakes in STZ-IMT504 rats by day 8, as well as IPGTTs on day 30. Significant increases in islet number and beta cell content were observed in STZ-IMT504 rats (day 33). Furthermore, after two to five IMT504 injections, blood glucose decreased, and an increase in pancreatic nestin (mainly in endothelial cells), PCNA and NGN3 production (in islets) was observed in STZ-IMT504 rats. CONCLUSIONS/INTERPRETATION: IMT504 induced a marked recovery of STZ-induced diabetes that correlated with early production of progenitor cell markers, such as nestin and NGN3.

[Diagnosis of tuberculosis in paediatrics]. / Diagnóstico de la tuberculosis en la edad pediátrica.

Tuberculosis is one of the most important health problems worldwide. There are an increasing number of cases, including children, due to different reasons in developed countries. The most likely determining cause is immigration from highly endemic areas. Measures to optimise early and appropriate diagnosis of the different forms of tuberculosis in children are a real priority. Two Societies of the Spanish Paediatric Association (Spanish Society of Paediatric Infectology and Spanish Society of Paediatric Pneumology) have agreed this Consensus Document in order to homogenise diagnostic criteria in paediatric patients.

[Thyroid carcinoma in pediatrics: a 30-year follow-up]. / Carcinoma de tiroides en pediatría: seguimiento a 30 años.

INTRODUCTION: The thyroid tumours are infrequent neoplasms of presentation in paediatric. The object of this study was to value therapeutic evolution and the survival throughout 30 years. MATERIALS: 28 cases with diagnosis of thyroid carcinoma. Were reviewed from 1978 to 2008. Were the variables to study: epidemiologists, methods used diagnostic, type of histology, later treatment and survival to 300 months to the treatment. We like considered significant p <0.05. RESULTS: 73.1% of the cases were of feminine sex. The average age was 12.3 years (1.6 to 19). The ultrasound was asked for the test more (78.5%). The RET mutation associated appear in three cases to MEN. The histology type to papillary was most frequent (50%). The total thyroidectomy (TT) was the surgery practice more (67.9%). The radioiodine (RI) was used in 46.4% of the cases. The substitute hormonal therapy was used 27 patients. 89.29% of the were series after 300 months free of disease. CONCLUSIONS: The treatment of the series these are hundreds throughout 30 years, but when valuing our experience we include / understand that: 1) the TT with selective lymphatic dissection, 2) it in the RI cases with positive to the body tracking and/or of factors of risk and 3) the substitute hormonal therapy, is the at the moment best offer alternatives to than we can these paediatric patients and prolong the survival in adult its age.